------------------------------------------------------------------------------ NewsBank, inc. - The Commercial Appeal - 1998 - Article with Citation ------------------------------------------------------------------------------ Headline: IT'S A START \ HOME CARE PROPOSAL OFFERS AN ALTERNATIVE Date: November 23, 1998 Section: Viewpoint Page: A6 Edition: Final Length: 583 words Text: TENNESSEE finally is moving toward helping elderly and disabled people find the long-term home care they need to stay out of nursing homes. A plan announced last week by state Health Commissioner Nancy Menke will not satisfy all the goals of home health care advocates. But it will be, as Tennessee Disabilities Coalition executive director Carol Westlake put it, "a decent start." Reaching even this intermediate point has not been easy. State funding for the care of older and disabled Tennesseans has favored nursing home care, leaving many who don't need such intensive care little access to financial relief. Gov. Don Sundquist's administration has been under heavy pressure this year to adopt a long-term care policy that would include financial coverage of services provided at home. The idea has great merit, not only for frail or ailing individuals who might enjoy more independent living, but also for state government through a corresponding reduction in skilled nursing home costs. A more militant advocacy group, the American Disabled for Attendant Programs Today, staged a protest in Menke's Nashville office as the commissioner announced the program elsewhere in the same building. Troopers removed the demonstrators, who argued the proposal is inadequate. The state-federal initiative is intended to provide the basis for a comprehensive long-term care program. Menke said community-based long-term care services are not yet available in some areas of the state. The plan will go before the federal Health Care Financing Administration, which will consider the state's request to waive Medicaid rules for the program. The plan would be paid for out of new revenues, rather than dip into the state's $750 million nursing home budget, as some advocates urge. To qualify, people must be Medicaid-eligible and meet medical criteria for nursing home admission. The state would insist on evidence of a support system, to ensure that participants can get by safely with home care. Services would include case management, homemaker services (chores, meals, errands), personal care services, day health programs away from the home, minor home modifications, special equipment, delivered meals, nursing services and transportation. It's disappointing that the administration had to be dragged into action on such an obvious need. The governor and health commissioner bristle at suggestions that they are reluctant to pay for home care out of Medicaid money that otherwise might flow to the nursing home industry because of some perceived obligation to a politically supportive special interest. Surely now, with a tobacco settlement that promises $4.8 billion to the state over 25 years, state officials can find enough money for a strong home health care program without unduly squeezing the nursing home industry or raising taxes. Sundquist is expected to recommend $10 million in state money, and the federal government would add $20 million, if the plan is approved. That would serve about 2,500 people a year, Menke said. But the effort should not stop there. The concept of home care as an alternative to nursing homes has enough logic behind it to qualify as a priority in future state budgets. Memo: editorial Copyright 1998 The Commercial Appeal, Memphis, TN Accession Number: 9811230271 ------------------------------------------------------------------------------